RESEARCH - Modulation of RANKL and osteoprotegerin expression in synovial tissue from patients with RA in response to DMARDs and correlation with radiologic outcome

[Guest guest]

Arthritis Rheum. 2008 Jun 24;59(7):911-920.

Modulation of RANKL and osteoprotegerin expression in synovial tissue

from patients with rheumatoid arthritis in response to

disease-modifying antirheumatic drug treatment and correlation with

radiologic outcome.

Haynes D, Crotti T, Weedon H, Slavotinek J, Au V, M,

-Thomson PJ, Ahern M, MD.

University of Adelaide, Adelaide, South Australia, Australia.

OBJECTIVE: To demonstrate the effect of treatment with

disease-modifying agents on the expression of osteoprotegerin (OPG)

and RANKL in the synovial tissue from rheumatoid arthritis (RA)

patients and to correlate these changes with radiologic damage

measured on sequential radiographs of the hands and feet. METHODS:

Synovial biopsy specimens were obtained at arthroscopy from 25

patients with active RA (16 of whom had a disease duration <12 months)

before and at 3-6-month intervals after starting treatment with a

disease-modifying agent. Immunohistologic analysis was performed using

monoclonal antibodies to detect OPG and RANKL expression, with

staining quantitated using computer-assisted image analysis and

semiquantitative analysis techniques. Serial radiographs of the hands

and feet were analyzed independently by 2 radiologists and a

rheumatologist using the van der Heide modification of the Sharp

scoring method. RESULTS: Thirteen patients achieved a low disease

state as defined by a disease activity score <2.6 while 19 patients

achieved an American College of Rheumatology response >20% after

disease-modifying antirheumatic drug (DMARD) treatment. Successful

DMARD treatment resulted in an increase in OPG expression and a

decrease in RANKL expression at the synovial tissue level, which

correlated with a reduction in erosion scores measured on annual

radiographs of the hands and feet.

CONCLUSION: Successful treatment-induced modulation of OPG and RANKL

expression at the synovial tissue level, resulting in a reduction in

the RANKL:OPG ratio, is likely to have a significant impact on

osteoclast formation and joint damage in patients with active RA.

PMID: 18576301

http://www.ncbi.nlm.nih.gov/pubmed/18576301

--

Not an MD